Tootles1975

Oh nice. I'm going through Roger Williams with Dr. Pohl, and I live in Johnston. I'm thinking I might get a surgical date in late October/early November hopefully.

@@rhodywoman I'm a fellow Rhode Islander! Who is your surgeon? We should chat!

Thanks to all of you for the feedback. I agreed that it was better to be safe than sorry and went for some of the tests today. The doctor called me back this afternoon and said everything looks good and was much more optimistic and friendly today. His verbiage changed from "if you get the surgery" to "when you get the surgery", so I'm taking that as a good sign! (And of course, it's great to have a clean bill of health.)

Thanks. I'll call the bypass surgeon's office tomorrow. I also called the vascular surgeon today but had to leave a message. I probably am worrying unnecessarily, but his tone just really threw me.

So I've been trucking along with all my appointments, completing everything but the endoscopy, one nutritionist visit and the sleep study. I met with the sleep study doctor today and his first response to me (after a bunch of questions then sitting in weird silence for ages while he typed on his computer) was that I have "much more important problems to worry about than a sleep study."

Apparently, he's very worried that I had a pulmonary embolism almost 20 years ago. I had a vena cava filter installed at the time and took blood thinners for six months and had an MRI afterward and was told it all cleared up on its own. I see a vascular surgeon (and have for the past five years) who monitors the filter --- I just recently had a X-ray of it to make sure it hadn't moved (he actually was going to suggest removing it until I told him I was preparing for gastric bypass). Neither he nor the bypass surgeon had any real concerns about this history, they just said they would prescribe blood thinning injections pre-op and/or post-op for me.

Well this doctor was very negative and thought I should reconsider the surgery given my history with the embolism, and kind of freaked me out by telling me that it was probably a bad thing that I'd had the filter for so long, and that he wanted to order a whole new battery of tests (Ultrasound, nuclear medicine, echo doppler, PFT) in addition to the sleep study (which...I don't even think I HAVE sleep apnea) and extensive boodwork to see if I have any pre-indicators for clotting, and then see me again in a month.

So now I'm a bit worried about all kinds of things, and while I know it's better to be safe than sorry, it makes me a bit angry that the vascular surgeon and the bypass surgeon didn't seem nearly as concerned about this as he was. He did concede he might be erring too heavily on the side of caution, but still seemed very negative about the whole thing. He said if it comes back that I do have genetic predisposition markers, I should really consider if it's worth doing the surgery or trying instead a medically supervised weight loss program. I tried to explain to him that my primary motivation for surgery is that it will severely minimize and maybe eradicate my diabetes, which diet/exercise won't do at this stage of advancement, even if I can lose and maintain, and that I know anyway that regular diets only generally have a 5% success rate long term, but he seemed pretty skeptical about my claims.

I'm not sure what to do now. My husband thinks I should cancel all the tests he scheduled and go to a different doctor for the sleep study. But now I'm worried, and I'd rather know if there's a problem or not. And another doctor may just raise the same concerns I suppose.

But...I don't want it to prevent me from getting the surgery either. If he refuses to approve, can I still go ahead with it?

It's just so weird to suddenly be worrying about a medical problem that happened 20 years ago, and hasn't really been an issue since.

Anyone have any embolism history that put obstacles in their way to surgery?

So I've been trucking along with all my appointments, completing everything but the endoscopy, one nutritionist visit and the sleep study. I met with the sleep study doctor today and he was very, very interested in the fact that I had a pulmonary embolism almost 20 years ago. I had a vena cava filter installed at the time and took blood thinners for six months and was told it all cleared up on its own. I see a vascular surgeon (and have for the past five years) who monitors the filter --- I just recently had a X-ray of it to make sure it hadn't moved (he actually was going to suggest removing it until I told him I was preparing for gastric bypass). Neither he nor the bypass surgeon had any real concerns about this history, they just said they would prescribe blood thinning injections pre-op and/or post-op for me.

Well today's doctor was very negative and thought I should reconsider the surgery given my history with the embolism. I was shocked by his overwhelming pessimism (he told me that it was probably impossible to have the filter removed since I've had it for 20 years--which is the opposite of what the vascular surgeon said) and that he wanted to order a whole new battery of tests (Ultrasound, nuclear medicine, echo doppler, PFT) in addition to the sleep study (which...I don't even think I HAVE sleep apnea) and extensive boodwork to see if I have any pre-indicators for clotting, and then see me again in a month.

Now I'm a bit worried about all kinds of things, and while I know it's better to be safe than sorry, it makes me worried/angry that the vascular surgeon and the bypass surgeon didn't seem nearly as concerned about this as he was. He did concede he might be erring too heavily on the side of caution, but still seemed very negative about the whole thing. He said if it comes back that I do have genetic problems, I should consider if it's worth doing the surgery or trying instead a medically supervised weight loss program. I tried to explain to him that my primary motivation for surgery is that it will severely minimize and maybe eradicate my diabetes, which diet/exercise won't do, and that I know regular diets only generally have a 5% success rate long term, but he seemed pretty skeptical about my claims.

I'm not sure what to do now. My husband thinks I should cancel all the tests he scheduled and go to a different doctor for the sleep study. But now I'm worried, and I'd rather know if there's a problem or not. But...I don't want it to prevent me from getting the surgery either.

It's just so weird to suddenly be worrying about a medical problem that happened 20 years ago, and hasn't really been an issue since.

Anyone have any embolism history that put obstacles in their way to surgery?

Thanks!

@swimbikefan -- Ooh, I'll definitely check out the performance pack. I bought mine at a Whole Foods (where they only had the full bags), but will have to look into it online too.

@7 Bites_Jen -- Yes, this is the only one I'll probably buy until I get to the 2-week pre-op liquid diet stage. I've definitely got Chike and unjury on my list, as well as Syntrax and Isopure to try.

Just met with dietician for my first visit on Friday. Unlike previous diet/nut visits, I liked her a lot. She was young, knowledgable about bariatric needs, didn't try to suggest I eat way too many carbs for a diabetic trying to lose weight, etc.

One thing I did wonder about though, is that, she said just 60 g of Protein a day would be necessary both now and post-op. I know on here, everyone says eat as much protein as you can and even advise up to 80 or even a 100 g a day. (I asked about that and she said, well, after surgery you're going to struggle just to get 60 in. Which is probably true, but...hopefully not for long?)

She also recommended Vega One plant-based protein powder--which has only 15 g per scoop. That seems a little low to me, though I did like the taste (couldn't really taste the powder at all honestly). Am wondering if I'm better off using two (or 1.5) scoops of Vega protein or if switching to a whey isolate powder with higher grams is better. (Right now, pre-op, no issues with digesting soy, whey or lactose.)

Any thoughts on the advantages of one or the other?

Appreciate everyone's feedback. It really is such a different process from person to person! I have scheduled all of my requirements for this month except the endoscopy which I'm waiting to hear back from the office on for scheduling, and the nutritionist who couldn't see me till August 1. So I could conceivably be done with all my appointments by mid-August maybe. My insurance (BCBS of Mass) doesn't have any six-month weight loss or lifestyle class or other waiting period requirements. Then if approval goes fine, it's usually 4-6 weeks after that for a surgery date. It'll hit right in the middle of my wedding anniversary and birthday, I bet.

Usually I am a terrible procrastinator at setting up doctor visits, and I kind of surprised myself in getting it all organized so quickly. I'm taking it as a good sign that I'm really committed and looking forward to this (despite my occasional doubtful moments). I imagine it's the first in many ways I'll begin to surprise myself through this journey.

I'm from Johnston and also going with Dr. Pohl for a bypass surgery. I just met with him last week for a consult and spent all this morning scheduling all the pre-op appointments. So many doctor visits in such a short time! Usually I'm a huge procrastinator about those so the fact that I did it right away is an encouraging sign of how much I really want this.

Hi all! I'm in Johnston, Rhode Island (next to Providence). Anyone have a favorite nutritionist in RI?

Wow.. I have a 4 month process that I am about 1/2 way through. That has been filled with the initial informational meeting, first meeting with the surgeon, 2 meetings with the dietitian, 2 psychological evaluation visits, three 2 hour educational workshops, a final visit with the surgeon and a 1.5 hour to 2 hour informational meeting (with my support person) with the nurse practitioner. In between all these visits I have had to have a chest xray, an EKG, blood work, medical clearance by a pulmonologist and then of course keep my PCP up to date with everything that has been going on. I actually am glad it has taken the amount of time that it has, as I wouldn't want to feel rushed. I am surprised to hear that your surgeon is requiring you to buy shakes from them, as my dietitian and my surgical binder lists what we need and encourages you to comparison shop.

Maybe I'll find out about more as I get further through it. But, yes, sounds like it'll probably take 3-4 months for me as well.

I'm not sure if it's required to buy shakes from them, but it's recommended. I probably won't though and will go my own way with the tips from the people at this forum. I haven't received a binder yet, unless the 60-page booklet they gave out at the info seminar doubles as the "binder."

omg same here Tootles! I was expecting... well I don't know what i was expecting, but something more 'doctory' than a conversation. I had my first consult earlier this week, and it was basically a chit chat... We just talked about goals, he agreed that the bypass was the right choice for me, and cautioned that it's not just a quick fix. He doesn't even want me to do a pre-op diet - he said it's only for patients over 350lbs. I weigh 310 right now (gained 8 lbs when i quit smoking last month!) But I kind of want to do it anyway if it will make the surgery safer. (I am f***** terrified of complications and surgery itself.)

But in the next 8 weeks, I need to get a physical, some blood work, cleared by therapist, and then see a dietitian twice. Easy peasy lemon squeezey.

What is your pre-op diet regimen?

Right?! I think I went in expecting him to have more rules and regulations for me. I had a lot of questions so maybe I covered a lot of that with my inquiries. But I don't know. His office also gives out a huge 60-page booklet at the information seminar you go to before you make the first appointment and that is very very explanatory of all that's involved. Maybe that's the shorthand so that the actual first visit can be really quick!

I started dieting myself on June 2. Restricting carbs to 50-70 g a day (or less when I can manage) and calories to 1200-1500. So far I've lost about 15 pounds and it's been working out well. I stopped drinking diet soda entirely or anything with carbonation, and most of my Snacks are Protein (lunchmeat, cheese, small amounts of peperoni), nuts, or sugar-free popsicles and Jello. I also really try to get at least 64-80 oz of Water a day. I've been surprised at how easy it's been so far. (I've lost weight on Weight Watchers and doing low carb before but I never restricted calories so much at the same time.) I think being so focused on knowing this is all to benefit me before surgery is really helpful. I'd like to lose about 30 more lbs (or even more) before surgery.

My official pre-op diet will be a liquid diet for two weeks before surgery, consisting of:

-3 Protein shakes of at least 15 grams a day (100-150 calories each) [i think the office sells a specific brand themselves, which...bothers me a little as it seems a bit convenient for them to profit. I may try to purchase my own. ]

-1 light dinner of 3 oz lean meat, poultry or fish with vegetables or a frozen low cal dinner (lean cuisine, smart choice, etc.)

-at least 64 oz Water per day

-1 Multivitamin with Iron daily (again they charge $25 per month for their own vitamins) or you an do 2 flintstones complete and extra Calcium of 1000 mg Calcium (viactive or caltrate or others, 2-3 per day)

Doctor also suggested starting Biotin before surgery to help with hair loss, but I'm torn on that as I already have a lot of pesky facial hair (I'm Italian) that I don't want to increase too!)

Your requirements are less than mine. In addition to two nutrionist visits, I have to do an upper endoscopy, gallbladder ultrasound, sleep apnea test and psych consult, plus get a letter from my PCP.

So I met with my surgeon for the first consult this week (Dr. Dieter Pohl in northern Rhode Island) and found the visit surprisingly anticlimactic! Heh. I guess because I'd done so much reading here and at other forums online since the initial seminar, there wasn't much he could tell me that I didn't already know!

I was a bit surprised by how fast it all could happen (4-6 weeks after I get through all my appts). He didn't mention anything about supervised weight loss requirements (I just have to see a nutritionist twice, along with all the other standard appointments). He does prescribe a two-week liquid pre-op diet, but didn't want me to lose any particular set amount before surgery, nor did he really pinpoint a goal he'd like me to reach afterward.

It's funny how different everyone's experience is, but I left feeling like it should be harder somehow!

This was too cute not to share:

I love this idea. And you could even (with some creativity) add non-fitness oriented NSVs too, like a shopping bag for having to replace your wardrobe, and a plane for not having to wear a seatbelt extender, etc. So fun, and congrats on your accomplishments!

You got the right idea! Increasing my Water and really thinking about if I was hungry, or thirsty or just plain old felt like eating out of habit was the hard part for me but ended up being the best thing. I don't tell myself I can't ever eat things again I just make them differently. For example it's BBQ time and I'll have cauliflower salad vs potato salad or something like that. If it's pizza I want, I make a cauliflower crust and add spinach or other veggies on top of the cheese.

Oh yes, I want to try that cauliflower crust, and also the oopsie rolls I see a lot of bloggers mentioning!

My husband and I both had rny on march 25th of this year. It was great doing it together. It has made it so much easier.... even the pre-op was easier. We were both miserable together. Haha! Neither of us have had any complications. I pretty much eat what I use to but I was already eating really healthy. He is a sugar addict and an emotional eater. This has been way harder on him. I used the 6 months prior to prepare myself for the surgery and what I could eat. He used it as a "eat everything possible". So he has dumped a few times and figured out pretty quickly what he can not eat. I havent even tried anything that would make me dump. He still wants sweets... but its all mental. He has always coped with life with sweets. I havent craved any sweets. So it all depends on yourself and how menatlly prepared you are.

Oh another couple! I'm sensing a pattern with these husbands just winging it. I'm trying to work out those emotional ties and cut them out now so the head hunger isn't too bad after!

Hi :-)

My husband and I are having surgery the same day, he will be sleeved and I will have a rny because if gerd. Tentative date is July 14th.

I am doing like you, gradually weaning off of the usual junk I eat, for the same exact reasons you write. In fact, I'm glad you posted to know that I'm not the only one! :-) My husband on the other hand, is not. He did stop drinking soda but that's about it. He says he's eating better but he thinks eating just an apple for lunch is enough. I am concerned that he doesn't know what he's getting into because he's not doing the research. But I just have to work on myself and let him do it his way I guess. Besides, I'm not perfect either and fudge up too. I find that I'm counting down the weeks so I can have this or that "one last time". That isn't healthy either because I think it's binge eating, isn't it?

Anyway, it sounds like you're doing great!!!

Oh wow, the same day! Good luck to you both. That will really help make things easier I bet. My husband is similar--he recently was diagnosed with a health condition and I get a lot of "What should I eat? Help!" questions. He gets easily frustrated too and wants to skip Breakfast a lot, which I always tell him is a bad idea!

I think it's human to have and want those "last" times. And who knows? Maybe you won't want them when you get there anyway--or not as much anyway!

Thank you so much for the support!

Hi, I'm new in the process as well. My first appointment was in May. My nutritionist looked at me with such an appalling look when I told her my typical diet! I was so upset because at this point I had been faithfully using myfitnesspal to cut my calories and try my best to reach nutrition goals. Well anyway after she looked at me that way she then explained how I should be eating and even tho I thought I was doing well I was still eating to many carbs. Then I met with the surgeon he told me to make 1 big change at a time like give up soda and try to eat like the NUT instructed me. I ended up leaving that appointment and created a new shopping list. I have since stuck to the NUTs diet gave up soda and increased Water and I am very full every day without hitting 1200 calories. Big difference from my 3k+ I was ingesting before. I have noticed after eating this way for a few weeks some things that I think I may want after taking a bite no longer taste as good or are not nearly as filling so I don't actually want to eat them.

Good for you! I've done other diet plans, including low-carb, before and had a lot of success short-term before my motivation failed, so I'm used to looking at labels and generally know what I should be eating and doing. Unfortunately I don't always do that which is why I'm buckling down anew right now. The Water consumption is what i'm tackling first because I really am hoping that helps with giving me the constantly full feeling. I'm trying to listen to my body more as well and really separate out the head hunger from the actual hunger! I hope I do as well as you have and that my tastebuds change as well! Thanks!

It's a process... for me, it was cold turkey all the way around. My surgeon didn't even put me on a pre-op diet. So I ate basically whatever I wanted up until the day of surgery. I was trying out Protein shakes, though. That's the one thing I wish I did EVEN MORE! Protein intake is really important for any WLS and a lot of times it will just make you sick to your stomach.

It's really awesome that you are trying to change your mindset so soon in the process. It's probably going to be extremely helpful for post-surgery.

I guess if I had to do it again, I would do Protein Shakes every day, aiming for 60g a day and a healthy dinner at night. I also probably would have the foods from the "full liquid" phase in my house constantly because I feel like I've been on this part of the diet forEVER! I also would recommend having some of your favorite foods here and there "for the last time."

Basically, easing yourself into it is a good thing. After surgery, you won't be able to work out right away, so eating right will be your life saver!

OH and Water, all day, every day! Get yourself a good water bottle with measurements on the side and NO straw. I have a Contigo 24oz one that I love! If you don't like plain Water, try out crystal light and Mio and things like that. You absolutely have to drink tons of water post-op and for the rest of your life!

I hope this helps a little! Good luck on your journey and keep us updated!

Thanks so much for sharing! A friend who had RNY three years ago told me that she went nuts trying all different shakes pre-op and then after post-op she hated all of them! Heh, so you may have been alright with waiting till after! I think my plan is going to be to try to do the liquid diet with protein shakes/broth/etc. for 2-4 weeks before surgery. So I still have some time but am keeping a list of shakes and protein powders that people here have recommended.

There will definitely be a few "last times" here and there too I'm sure.

Ooh yes, I have to get a really good/big water bottle. I've been drinking about 68 oz a day (4 poland spring sized bottles), but could probably do better with a bigger container. I know I can't use a straw post-op but am a little tempted to do it now, cause you can suck that water down so much faster/easier! Heh.

Thanks again!

I would like to put my little comment to you. Anticipating your surgery is one thing but realizing that you are to mentally and physically for a complete lifestyle change.

This won't be just for a little while but for the rest of your life.

Trying to just do these changes for a short while and thinking that it will help won't do.

Change your eating and don't so call 'cheat'. This isn't a game. Need to change your mindset completely.

Vegetables are very important along with lean Protein. I have completely done all this and feel so much better. I "juice" vegetables lots of greens and carrots almost every day. I just ate a grilled skinless chicken breast, cherry tomatoes. I won't be hard to eat well.

In the afternoon I had some cottage cheese which I used to hate but now am using it every day. With that I had some natural juice peaches from

Aldi's. Nice prices make it easier to buy what you need.

I'm not trying to do these things for "just a little while." What I'm concerned about is pacing myself as I try to overhaul bad habits/emotional ties and convert to the new lifestyle I'm seeking. If I try to change everything at once, I think that might be setting myself up to fail because it's too overwhelming. So that's why I'm starting now before I even have a surgery date, and I'm working on the diet and emotional stuff, then when I'm used to that and feel I have it under control, I'll gradually introduce each of the other elements of this new life.

I'm just wondering how other people did that. Some are cold turkey who ate the same way they always did up until the pre-op diet or even day of surgery if they didn't have one. Others started weeks or months earlier. I'm trying to find a good handle on that.

Hi all,

I'm just getting started with this process and have a first consult at the end of this month with the surgeon that I'm hoping will perform Gastric Bypass surgery on me. (So far, I've only attended the seminar, made up my mind to do it, and made this first appointment.)

I'm type-2 diabetic and had read that some surgeons won't do the surgery if A1C is too high. At last PCP visit, mine was near 10, which I'm not happy about at all. Just this week, I've begun to tackle that by restricting carbs (40-60 per day for now, lower with time hopefully). I'm also bumping up Water and exercise, stopped drinking any soda/carbonation, and am planning to work on eating slower and not drinking with meals. I'm thinking once I get some of the appointments underway, I'll start trying Protein Powder and shakes and upping Vitamin intake, including Biotin for the Hair loss, etc.

But I don't want to be too restrictive now in fear I'll burnout/fail and go back to bad habits without even a surgery date in sight. I know a lot of that is attitude/willpower, and I'm trying think of the surgery as a reward for all the hard work. I'm guesstimating I have about 20-30 weeks before surgery actually happens.

How did you manage the time between your decision and your surgery date/pre-op diet?

Just wanted to thank you all again. I've considered all you've said (it was especially encouraging that those of you who did have various problems post-op still considered it the best decision you made) and it eased my mind that 85% is good enough and to leave the rest to faith. My first surgeon appointment is June 26 (with Dr. Dieter Pohl, if any of you are in Rhode Island)!

85% convinced. How do I get to 100%?

You don't.. They're only taking 85% of your stomach, so you're good to go.

It's hard to choose, but this might be my favorite response.